title: Use of continuous infusion pumps during radiation treatment.
abstract: BACKGROUND
  Despite increasing chemoradiotherapy treatment, there is a paucity of information regarding the effects of radiation exposure on ambulatory infusion pumps used to deliver chemotherapy or other essential medications. The aim of this overview is to present the available evidence on this subject, heighten awareness within the clinical community, provide considerations for minimizing possible negative effects on patient care, and encourage the monitoring of infusion devices after exposure to radiation or electromagnetic interference.
  
  
  METHODS
  Published literature was systematically searched using MEDLINE and EMBASE; gray literature was searched using Google and an environmental scan of relevant Web sites. A multidisciplinary working group reviewed the compiled evidence, and a draft of the document was sent to health professionals from various disciplines for an external review.
  
  
  RESULTS
  Four reports and three manufacturer device alerts were identified that suggest a risk of pump malfunction as a result of radiation exposure. The estimated cumulative dose at which pump failure has been reported ranges from 28.5 to 42 Gy; however, additional clinical investigations should be undertaken. Pump relocation, pump shielding, and assessment of the pump after radiation exposure are most commonly suggested to minimize pump malfunction related to radiation exposure. A list of additional considerations is offered for those developing institution specific policies and procedures based on the available evidence and expert consensus.
  
  
  CONCLUSIONS
  The varied and unpredictable results of radiation exposure on infusion devices suggest that additional testing should be carried out to determine the limits of dose exposure and to raise awareness around this patient safety issue.
authors.affiliation: Cancer Care Ontario, Toronto, Canada. Kate.Bak@cancercare.on.ca
authors.forename: Kate
authors.initials: K
authors.lastname: Bak
authors.forename: Eric
authors.initials: E
authors.lastname: Gutierrez
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lockhart
authors.forename: Michael
authors.initials: M
authors.lastname: Sharpe
authors.forename: Esther
authors.initials: E
authors.lastname: Green
authors.forename: Sarah
authors.initials: S
authors.lastname: Costa
authors.forename: Sherrie
authors.initials: S
authors.lastname: Hertz
authors.forename: Leonard
authors.initials: L
authors.lastname: Kaizer
authors.forename: Anthtony
authors.initials: A
authors.lastname: Whitton
authors.forename: Padraig
authors.initials: P
authors.lastname: Warde
mesh_terms: D000553:Ambulatory Care; D019544:Equipment Failure Analysis; D005720:Gamma Rays; D006801:Humans; D007260:Infusion Pumps; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*